Random_10 Flashcards Preview

Random > Random_10 > Flashcards

Flashcards in Random_10 Deck (100):
1

DDx for pneumatosis intestinalis

  • bowel necrosis
    • most important and life threatening
  • mucosal disruption
    • peptic ulcer dz
    • endoscopy
    • enteric tubes
    • trauma
    • child abuse
    • UC or Crohn's disease
  • increased mucosal permeability - often associated with immunosuppression
    • AIDS
    • organ transplantation
    • chemotherapy
    • steroid
    • graft vs host dz
  • pulmonary conditions - air from disrupted alveoli dissect along the bronchopulmonary interstitium and retroperiteoneum along the visceral vesels to the bowel wall
    • COPD
    • asthma
    • mechanical ventilation
    • ptx
    • pneumediastinum

2

Cystic pneumatosis

vs 

Linear pneumatosis

  • cystic pneumatosis -
    • well-defined blebs or grapelike clusters of spherical air collections in the subserosal region
    • usually benign
    • these air cysts may rupture and result in benign pneumoperitoneum
  • linear pneumatosis -
    • streaks of gas within and parallel to the bowel wall
    • maybe benign or ischemic causes

3

Sigmoid volvulus

vs

Cecal volvulus

  • sigmoid volvulus
    • point towards LLQ
    • proximal colon and small bowel are dilated
  • cecal volvulus
    • point towards RLQ
    • proximal small bowel dilated
    • distal colon collapsed
    • vs cecal bascule - folding rather than a twisitng of a mobile cecum

4

Courses of pelvic muscles

iliopsoas

piriformis

pelvic diaphragm

  • Iliopsoas
    • psoas m. joins the iliacus m.
    • lesser trochanter
  • Piriformis
    • anterior sacrum to
    • greater trochanter
  • Pelvic diaphragm
    • anterior - levator ani
    • posterior - coccygeus

5

Level of aortic bifurcation

Level of iliac artery bifurcation

  • Aorta bifurcates into common iliac arteries at the level of iliac crest
  • Common iliac arteries bifurcates at the level of pelvic brim - marked on CT by the transition b/t the convex sacral promontory and the concave sacral cavity 

6

Denonvillier's fascia

tough barrier b/t the prostate and rectum

preventing spread of disease from one organ to the other

7

Cervical malignancies

  • 85% - squamous carcinoma
  • 15% - adenocarcinoma
  • low attenuation or isoattenuating compared to normal cervix - reduced vascularity, necrosis or ulceration
  • II-b - invasion of the parametrium - no longer surgical candidate

8

Endometrial malignancy

Hematogenous spread to lung, bone, liver, and brain is much more common with endometrial cancer than cervical cancer

9

In adnexal torsion, the uterus is usually deviated to the affected side

In adnexal torsion, the uterus is usually deviated to the affected side

10

Trough sign

Vertical lucency 

indicates an impaction from posterior shoulder dislocation

11

When disc material migrates from the parent disc, it is termed a "sequestered" or "free fragment"
:

When disc material migrates from the parent disc, it is termed a "sequestered" or "free fragment"

12

By noting the density differences b/t the "mass" and the thecal sac

By noting the density differences b/t the "mass" and the thecal sac

  • if "mass" is denser than thecal sac - it is a bulged disc or sequestered disc
  • if "mass" is isodense as the thecal sac - it is a Tarlov cyst/perineural cyst or conjoint nerve root

13

Types of spinal stenosis

Types of spinal stenosis

  • central canal stenosis
  • lateral recess stenosis
  • neuroforaminal stenosis

14

Central canal stenosis

  • most useful CT criteria for diagnosing central canal stenosis - obliteration of epidural fat & flattening of the thecal sac
  • most common cause of central canal stenosis - fact degenerative disease 
  • other causes
    • hypertrophy of ligamentum flavum - actually "buckling"
    • paget's disease
    • DISH with ossification of the posterior longitudinal ligament

15

Neuroforaminal stenosis

Causes of neuroforaminal stenosis

  • degenerative joint disease
    • osteophytes arising from the vertebral body or the facet
  • disc protrusion
  • postop scar 

16

DDx of diseae entities that have sequestrum

DDx of diseae entities that have sequestrum
 
  • osteomyelitis
  • EG
  • desmoid tumor
  • malignant fibrous histiocytoma

17

Ortner Syndrome

Cardiovocal hoarseness

  • In this syndrome, the LRLN is injured as it loops around the aorta at the aortopulmonary window and along the outer side of the ligamentum arteriosum due to compression or traction caused by changes in the anatomy of the heart or great vessels.
  • The left vagus nerve gives rise to the LRLN at the level of the aortic arch, which supplies muscles of the left larynx except the cricothyroid muscle (supplied by the superior laryngeal nerve).
  • In isolation, laryngeal findings cannot differentiate RLN palsy from high vagal lesions; however, coincident pharyngeal constrictor atrophy and ballooning of the pharyngeal wall suggest pharyngeal plexus injury due to brain stem or central vagal nerve lesions. Moreover, coincident palsies/atrophy of the trapezius and sternomastoid muscles indicate associated spinal accessory nerve injury with involvement at the jugular foramen or high carotid sheath (above the level of the posterior belly of the digastric muscle).
  • Evaluation of the heart, aorta, and supra-aortic thoracic vessels to rule out compression or traction along the thoracic course of RLNs should be part of screening for possible underlying causes of RLN paralysis.

18


"out of proportion TO..."


"Out of proportion TO..."

19

Fracture of the lateral talar process

“snowboarder fracture”

  • often missed - anterolateral ankle pain related to such a fracture often mimics that of an anterior talofibular ligament sprain. Unfortunately, there is a high likelihood of developing osteoarthritis following lateral talar fractures, thus reinforcing the need for a correct diagnosis and optimal management.
  • the lateral process is often identified inferior to the tip of the fibula. Any lucency, as in this index case, should prompt the diagnosis. Detailed evaluation of a well-positioned lateral radiograph with regard to the the angle of Gissane should demonstrate a well-defined smooth “V” shape of the lateral process.
  • CT should be suggested for further evaluation if radiographic findings are equivocal, as well as to define the full extent of the fracture.
  • lateral process fracture staging system (Hawkins) is:

    Type I: Nonarticular chip fracture
    Type II: Intra-articular, single fracture line
    Type III: Intra-articular, comminuted

20

Normal and abnormal ankle xrays

Lateral talar process fracture

21

Gissane's angle

Gissane's angle

22

Left PICA stroke

ALWAYS look at the cerebellar hemispheres!

REMEMBER:

Cerebellar stroke - symptoms are IPSILATERAL!!!

Fibers have already crossed over!

23


When describing perianal abscess, it is important to differentiate b/t

intra-sphincteric

vs

extra-sphincteric

abscess


When describing perianal abscess, it is important to differentiate b/t

intra-sphincteric

vs

extra-sphincteric

abscess

24

Cause of post aneurysm coiling headache?

  1. RARE - delayed rupture of the aneurysm, which may have been ruptured partially during the coiling process
  2. COMMON - thrombosis of the aneurysm inciting an inflammatory response

25

The RLN arises from the vagal trunk in the thorax. On the left, the RLN arises at the level of the aortic arch; it crosses the aortic arch and hooks around the ligamentum arteriosum. On the right side, the RLN hooks around the first part of the subclavian artery, then ascends in the groove between the trachea and the esophagus. Because of its longer thoracic course, LRLN palsy is more common than right RLN palsy. The left RLN comes into close contact with left lung apex, aorta, pulmonary artery, ligamentum arteriosum, trachea, esophagus, and mediastinal lymph nodes and accordingly is vulnerable to compression or traction by pathological conditions of any of these structures.

The RLN arises from the vagal trunk in the thorax. On the left, the RLN arises at the level of the aortic arch; it crosses the aortic arch and hooks around the ligamentum arteriosum. On the right side, the RLN hooks around the first part of the subclavian artery, then ascends in the groove between the trachea and the esophagus. Because of its longer thoracic course, LRLN palsy is more common than right RLN palsy. The left RLN comes into close contact with left lung apex, aorta, pulmonary artery, ligamentum arteriosum, trachea, esophagus, and mediastinal lymph nodes and accordingly is vulnerable to compression or traction by pathological conditions of any of these structures.

26

The right and left RLNs supply all the muscles of the larynx except the cricothyroid muscle as well as sensory supply to the larynx below the VCs and the upper part of trachea (supplied by the superior laryngeal nerve).

The right and left RLNs supply all the muscles of the larynx except the cricothyroid muscle as well as sensory supply to the larynx below the VCs and the upper part of trachea (supplied by the superior laryngeal nerve - also a branch of the vagus nerve).

27

Left atrial, aortic, or pulmonary artery enlargement is encountered in various congenital heart diseases and can result in compression of the LRLN. 

Aneurysms of different etiologies, direct injury in ductal ligation, or transcatheter closure of patent ductus arteriosus or upon repair of aneurysms are all associated with risk of LRLN palsy. Primary and secondary pulmonary hypertension, with enlargement of the pulmonary artery (as in our case) are also reported to cause LRLN palsy. Some patients with arteriosclerotic heart diseases can suddenly suffer LRLN paralysis due to rapid onset of left ventricular failure with sudden pulmonary hypertension with acute dilatation of the pulmonary vessels. This phenomenon has been ter­med dynamic dilation.

28

CT findings of VC paralysis include decreased volume of the thyroarytenoid and posterior cricoarytenoid muscles due to denervation atrophy, anteromedial rotation of the arytenoid cartilage, dilation of the ipsilateral laryngeal ventricle, pyriform sinus and vallecula, and thinning and medialization of the ipsilateral aryepiglottic fold. On coronal images, pointing of the VC and flattening of the subglottic angle are seen. 

CT findings of VC paralysis include decreased volume of the thyroarytenoid and posterior cricoarytenoid muscles due to denervation atrophy, anteromedial rotation of the arytenoid cartilage, dilation of the ipsilateral laryngeal ventricle, pyriform sinus and vallecula, and thinning and medialization of the ipsilateral aryepiglottic fold. On coronal images, pointing of the VC and flattening of the subglottic angle are seen. 

29

Acute Disseminated Encephalomyelitis

ADEM

  • ADEM is an autoimmune demyelination disorder
  • occurs 5 - 14 days after a viral illness or vaccination
  • peak age 3-5 y/o
  • The classic appearance is multifocal T2 and FLAIR hyperintensities in the brain and spinal cord (esp in the dorsal white matter) with multifocal neurologic deficits.
  • The appearance of ADEM is often identical to multiple sclerosis, although ADEM is a monophasic self-limiting disorder.
  • Steroids and/or plasmapheresis is the treatment of choice.

30

Pleural mets secondary to thymoma

"Drop mets"

Dry - no associated pleural effusion

31

Credo

Credo

A statement of the beliefs or aims that guide someone's actions: "he announced his credo in his first editorial".

32

Carpal boss

  • bony protuberance at the dorsal base of the 2nd and 3rd metacarpals
  • may be a result of a congenital ossicle (os styloideum), or traumatic, or degenerative osteophyte formation
  • symptoms: pain and mass along dorsal wrist

33

Elastofibroma dorsi

  • benign, fibroelastic soft tissue tumor
  • possibly a pseudotumor, reactive in nature, due to mechanical friction of scapula against the ribs
  • classically found in the infrascapular region, deep to the serratus anterior and latissimus dorsi musculature
  • 60% bilateral
  • F:M = 5:1, mean age 65 y/o
  • often asymtomatic - incidentally found on CT
    • may cause moderate pain and clicking, snappy, clunking of scapula with movement
  • surgical resection if symptomatic
  • no malignant transformation
  • CT
    • poorly defined soft tissue mass in the infrascapular or subcapsular region attenuation similar to that of adjacent skeletal muscle
    • may have internal septations or scattered areas of fat attenuation
    • atypical features such as bone destruction or intense contrast enhancement should raise the suspicion of tumor of a different cause - sarcoma, metastasis

34

DDx for intradural extramedullary tumors

  • nerve sheath tumors - neurofibroma, schwannoma
  • meningiomas
  • other:
    • primary: ependymomas, epidermoid tumors, paragangliomas, lipomas, plasmacytomas, and chloromas
    • mets

35

Lymphangiomatosis

vs

Lymphangiomyomatosis

vs

Lymphangioma

vs

Lymphangiectasis

  • lymphangiomatosis
    • similar to lymphangiectasis - dilated lymphatic structures
  • lymphangiomyomatosis
    • middle aged women, thin walled cysts, PTX, tuberous sclerosis
  • lymphangioma
    • aka cystic hygroma
  • lymphangiectasis
    • dilated lymphatic structures

36

Pulmonary lymphangiomatosis

  • smooth diffuse interlobular septal thickening
  • diffuse effacement of mediastinal fat
  • pleural and pericardial effusions
  • mild mediastinal lymphadenopathy

37

Systemic lymphangiomatosis

Infiltrating mesenteric and retroperitoneal fluid density

  • multifocal proliferation of lymphatic vessels
  • clinical presentation depends on anatomic site and extension of involvment
    • anorexia
    • pain
    • hepatosplenomegaly
    • ascites
    • resp distress

38

Emmy

vs

Academy

vs

Tony

vs

Grammy

  • Emmy - TV
  • Academy - film
  • Tony - theatre
  • Grammy - music

39

DDx of calcification in the lungs:

Pulmonary ossification

vs

Metastatic pulmonary calcification

vs

Chronic granulomatous disease

  • pulmonary ossification
    • dendriform pulmonary ossification
      • true metaplasia of pulmonary fibroblasts into osteoblasts in response to chronic insult
    • nodular pulmonary ossification
      • due to repetitive alveolar hemorrhage
  • metastatic pulmonary calcification
    • chronic renal insufficiency
    • elevated serum calcium
  • chronic granulomatous dz
  • silicosis
  • amyloidosis

40

Dendriform pulmonary ossification

  • rare, < 100 reported cases
  • arborizing pattern of calcific reticular opacities and interstitial thickening, most prominent in peripheral lung bases
  • demogrpahics: elderly males with co-existing chronic interstitial lung disease
  • due to true metaplasia of pulmonary fibroblasts into osteoblasts
  • not associated with bad prognosis

41

Arcuate line

  • a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath
  • located at about 1/3 of the distance b/t umbilicus and pubic crest
  • above the arcuate line - rectus abdominis is surrounded by an anterior and posterior layer of rectus sheath
  • below the arcuate line - all 3 muscle layers make up the rectus sheath anterior to the rectus abdominis
    • rectus sheath hematoma can be free to cross the midline 

42

haven

a place of safety or refuge

haven

a place of safety or refuge

43

DDx for multiple focal hypoechoic splenic lesions

  • abscesses
  • metastases (esp melanoma)
  • lymphoma
  • sarcoid
  • infarct - if wedge shaped and extends to periphery

44

normal kidney size


9-12 cm

45

epidermoid

vs

dermoid cyst


epidermoid cyst

shows restricted diffusion!

46

Solitary lytic lesion of the skull

DDx

  • common
    • anatomical variants: vascular channels, venous lakes, arachnoid granulations
    • surgical defects: burr hole
    • metatasis: breast, lung, prostate most common
  • less common
    • epidermoid cyst - restricted DWI
    • LCH/EG - bevel edges (inner table involved > out table)
    • plasmacytoma
    • Paget disease - osteoporosis circumscripta
    • hemangioma - lytic diploic space lesion, well-circumscribed, "spoke-wheel" or "reticulated" pattern, strong enhancement post contrast
    • dermoid cyst - fat density
    • leptomeningoceal cyst - "growing fracture", late complication of skull # with dural laceration
    • osteomyelitis - complication of trauma, sinusitis, mastoiditis; "pott puffy tumor" - subperiosteal abscess of the frontal bone
  • rare
    • encephalocele
    • neurosarcoidosis
    • aggressive fibromatosis
    • sinus pericranii

47

  • centered in the diploic space
  • expansile
  • well-defined margins
  • spoke-wheel, reticulated appearance
  • avid enhancement

48

Do not diagnose uterine AVF unless the 

peak systolic velocity exceeds...?

PSV > 160cm/sec!!

together with low resistance diastolic flow

49

Stenson's duct

vs

Wharton's duct

  • Stenson's duct - parotid duct
  • Wharton's duct - submandibular dut

50

Definition of burst fracture

Involving both anterior and middle columns

51

"Microdisc"


Microdisc

Microscopic disc surgery - scraping off herniated disc portions

52

Sacralization of the right aspect of L5

with pseudoarticulation with S1

53

Radiographic findings of pneumonia

can lag behind clinical findings

Radiographic findings of pneumonia

can lag behind clinical findings

54

Post-transplantation lymphoproliferative disorder

PTLD

  • occur in post-transplant as a consequence of immunosuppressive drugs
  • a spectrum of histologic findings - from benign lymphoid hyperplaisa --> malignant lymphoma
    • most cases: B cell proliferation
  • causes multifactoral
    • EBV infection is associated with most cases of PTLD
  • risk factors for PTLD
    • EBV infection
    • age
    • type of organ transplant
    • immunosuppression regimen
  • PTLD is typically aggressive - if untreated, can progress to disseminated malignancy

55

Increased phasicity and pulsatility

of the hepatic veins and portal veins

Right heart failure

or

Tricuspid regurgitation

56

SAH/IVH can redistribute to the contralateral side

SAH/IVH can redistribute to the contralateral side

57

Radiation dose to the fetus on a head CT is close to 0

a head CT is estimated at <0.01 rad

background radiation during the entire gestation period is estimated at 0.23 rad

Radiation dose to the fetus on a head CT is close to 0

a head CT is estimated at <0.01 rad

background radiation during the entire gestation period is estimated at 0.23 rad

58

Always look at interpeduncular cistern for acute SAH!!!

Always look at interpeduncular cistern for acute SAH!!!

59

Gated study for

cardiac or thoracic aorta examination


Always better!

  • lower dose
  • better quality

60

CO --> globus pallidus

Methanol --> putamen

CG

MP

CO --> globus pallidus

Methanol --> putamen

CG

MP

61

Wernicke's encephalopathy

  • CT - usually normal
  • MR - T2 hyperintensity in:
    • medial thalami
    • tectal plate
    • periductal grey
    • mammary bodies

62


Progression of ankylosing spondylitis in spine

  1. squaring of the anterosuperior vertebral body margins
  2. corner erosions
  3. sclerosis in repair phase
  4. shiny corners

63


What type of vertebral fracture do AS pts get?


Chalk stick fracture

64

DDx for

multiple intradural extramedullary spinal lesions

  • neoplastic
    • neurofibromatosis
    • schwanomma
    • neurofibroma
    • meningioma
    • mets
      • drop mets from ependymoma/medulloblastoma/astrocytoma
      • other mets - lymphoma/breast/lung
  • infectious/inflammatory
    • arachnoiditis
    • sarcoid
    • TB
    • GBS

65

Tracheal stenosis

  • 90% iatrogenic - secondary to intubation or tracheostomy
  • normal tracheal dimension
    • men 25mm
    • women 21mm
  • most often occur in proximal cervical (subglottic) trachea
  •  

66

Normal endometrial thickness

  • pre-menopausal pt
    • < 15mm
  • post-menopausal pt
    • no bleeding < 11mm
    • bleeding < 5mm

67

Hepatic veno-occlusive disease is a known complication of bone marrow transplant

Hepatic veno-occlusive disease is a known complication of bone marrow transplant

68

Hyperextension teardrop fractures typically involve the anterior inferior endplate (particularly of C2).

Flexion teardrop fractures involve the anterior superior endplate.

Hyperextension teardrop fractures typically involve the anterior inferior endplate (particularly of C2).

Flexion teardrop fractures involve the anterior superior endplate.

69

"low level internal echoes" in the fluid

complicated by infection or hemorrhage

"low level internal echoes" in the fluid

complicated by infection or hemorrhage

70


CXR in a seizure patient

  • r/o aspiration
  • r/o should dislocation

71

Fournier gangrene

vs

Peyronie's disease

  • Fournier gangrene - necrotizing infection of the perineum
  • Peyronie's disease - fibrosis +/- calcification of the tunica albuginea - painful and/or curved penis on erection (most commonly affecting the dorsal side)

72

Penile blood supply

  • internal pudendal artery divides into
    • common penile artery
      • dorsal penile
      • bulbourethral
      • cavernosal
    • perineal arteries

73

Types of priapism

Priapism - persistent complete or partial erection for > 4 hours in the absence of sexual stimulation

  • Ischemic priapsim
    • veno-occlusive, low-flow, painful
    • more common
    • rigidity of the corpora cavernosa with little arterial flow
    • often caused by ED drugs and sickle cell pts
    • urologic emergency
    • Rx: coporal aspiration of blood and injection of phenylephrine; surgery
  • Nonischemic priapsim
    • arterial, high-flow, painless
    • less common
    • results from unregulated arterial inflow into the lacunar spaces of the penile cavernosa 
    • most common cause is injury to the cavernosal artery resulting from blunt trauma (straddle injury during sexual intercourse)
    • not a urologic emergency
    • Rx: observation; doppler-guided compression of the injured artery; IR - embolization

74

Gastric arterial supply

 

  • celiac trunk - left gastric
  • common hepatic - right gastric
  • splenic artery - short gastric
  • right and left gastroepiploic artery

75

Parathyroid glands usually deep to the thyroid gland

on US

Parathyroid glands usually deep to the thyroid gland

on US

76

3 planes of ultrasound examination of fetal brain

  • trans-ventricular
  • trans-cerebellar
  • trans-thalamic

77

U/S findings associated with agenesis of corpus collosum

ACC

  • absence of the cavum septum pellucidum
  • colpocephaly
  • high-riding 3rd ventricle
  • widening of the inter-hemispheric fissure
  • race car configuration parallel lateral ventricles

78

Isolated ACC is rare

ACC is often associated with what anomalies?

  • lissencephaly
  • schizencephaly
  • periventricular nodular heterotopia
  • polymicrogyria

79

"Mucocele of the appendix"

  • F:M > 4:1
  • 0.3% prevalence
  • 3 histological types
    • focal or diffuse hyperplasia
    • mucinous cystadenoma
      • most common
      • benign
      • 20% rupture --> pseudomyxoma peritonei
    • mucinous cystadenocarcinoma
      • much less common
      • greater risk of rupture

80

Bubbly or lytic bone lesions

FEGNOMASHIC

  • fibrous dysplasia
  • enchondroma, EG
  • GCT
  • non-ossifying fibroma/NOF
  • osteoblastoma
  • metastasis, myeloma
  • aneurysmal bone cyst
  • solitary bone cyst/UBC
  • hyperparathyroidism - brown tumor, hemangioma
  • infection
  • chondroblastoma, chondromyxoid fibroid

Bubbly or lytic bone lesions

FEGNOMASHIC

  • fibrous dysplasia
  • enchondroma, EG
  • GCT
  • non-ossifying fibroma/NOF
  • osteoblastoma
  • metastasis, myeloma
  • aneurysmal bone cyst
  • solitary bone cyst/UBC
  • hyperparathyroidism - brown tumor, hemangioma
  • infection
  • chondroblastoma, chondromyxoid fibroid

81

Multiple lytic lesions

FEEMHI

Multiple lytic lesions - FEEMHI
 
  • fibrous dysplasia
  • enchondromas, EG
  • metastasis, myeloma
  • hyperparathyroidism - brown tumor, hemangiomas
  • infection

82

Lytic epiphyseal lesions

CCIG

Lytic epiphyseal lesions - CCIG

  • chondroblastoma
  • GCT
  • infection
  • geode

83

Lytic lesions in < 30 y/o

  • chondroblastoma
  • NOF
  • ABC
  • UBC
  • EG
  • infection

Lytic lesions in < 30 y/o

  • chondroblastoma
  • NOF
  • ABC
  • UBC
  • EG
  • infection

84

Dense Bones

Regular Sex Makes Occasional Perversions Much More Pleasurable And Fantastic

Dense Bones

Regular Sex Makes Occasional Perversions Much More Pleasurable And Fantastic

  • Renal osteodystrophy
  • Sickle cell disease
  • Myelofibrosis
  • Osteopetrosis
  • Pyknodysostosis
  • Mastocytosis
  • Mets - breast and prostate (5 bees lick pollen - brain (medulloblastoma), bronchogenic, bone, bowel, bladder), lymphoma, prostate)
  • Paget's disease
  • Athletes
  • Fluorosis

85

High-riding shoulder

DDx

High-riding shoulder

  • RA
  • CPPD
  • trauma
  • rotator cuff tear

86

Widened tear drop in the hip

DDx

Widened tear drop in the hip

  • infection
  • trauma
  • AVN
  • PVNS
  • synovial osteochondromatosis

87

Permeative lesion in a child

DDx

Permeative lesion in a child
 
  • Ewing's sarcoma
  • infection
  • EG

88

Cortical holes

Pseudopermeative lesion

DDx

Cortical holes

Pseudopermeative lesion

DDx

  • Osteoporosis
  • Radiation
  • Hemangiomas

89

CPPD-associated disorders

 

CPPD-associated disorders

  • primary hyperparathyroidism
  • gout
  • hemochromatosis

90

Dense base of the skull

DDx

Dense base of the skull

DDx

  • fibrous dysplasia
  • Engelmann's disease
  • Von Bochem's disease
  • Paget's disease
  • meningioma
  • pyknodysostosis
  • osteopetrosis

91

Geodes

DDx

Geodes

DDx

  • CPPD
  • degenerative OA
  • RA
  • AVN

92

Bony Sequestration

DDx

Bony Sequestration DDx

  • Infection
  • EG
  • Osteoid osteoma
  • fibrosarcoma
  • lymphoma

93

Arthropathy based on distribution in the hands and wrists

Distal

vs

Proximal

Arthropathy based on distribution in the hands and wrists

  • Distal
    • psoriasis
    • Reiter's syndrome
    • OA
  • Proximal
    • RA
    • CPPD

94

Joints that exhibit erosions with OA

Joints that exhibit erosions with OA

  • TMJ
  • AC joint
  • SI joint
  • symphysis pubis

95

Rib lesions DDx

FAME

Rib lesions DDx

FAME

  • fibrous dysplasia
  • ABC
  • mets and myeloma
  • EG and enchondroma

96

AUTOMATICS that must be mentioned in every case

< 30 y/o

> 30 y/o

AUTOMATICS that must be mentioned in every case

  • < 30 y/o - infection, EG
  • > 30 y/o - infection, Mets/myeloma

97

Pyknodysostosis

Pyknodysostosis

  • autosomal recessive bone dysplasia
  • osteosclerosis
  • short stature

98

Normal kidney size

11 +/- 2 cm

9 - 13 cm

99

Gallbladder sludge

  • echogenic, layering, mobile
  • non-shadowing
  • echogenicity is due to crystals - cholesterol and calcium bilirubinate
  • DDx
    • pus
    • blood
  • associated with
    • pregnancy
    • fasting
    • TPN
    • rapid weight loss
    • critical illness

100

Approximately 10% RCC may be echogenic enough to mimic the appearance of AML

Approximately 10% RCC may be echogenic enough to mimic the appearance of AML

  • can order CT or MR for confirmation
  • features suggestive of RCC - cystic elements; hypoechoic halo; calcifications
  • features suggestive of AML - posterior acoustic shadowing